Building Narrative Power for Racial Justice and Health Equity

By Corrina Wainwright, Open Society Foundations

Contents

Introduction

To improve the health and well-being of communities oppressed by racism and white supremacy, advocates for justice need to challenge some deeply held cultural assumptions, values, and practices.

This prerogative raises a series of questions:

How can we disrupt the narratives that perpetuate racism and white privilege?
What counternarratives and stories need to be told to shift cultural consciousness?
What kinds of alliances, infrastructure, and institutions are necessary?

During a two-day convening, health practitioners, race theorists, academics, activists, community organizers, and cultural and media strategists met to examine these questions, reflect, learn, and share ideas.

This convening report summary seeks to spark wider conversations—particularly in this fraught political moment—and mobilize people and resources in an effort to advance narratives that promote racial justice and expand our understanding of health, human rights, and the public good.

Narrative, Racism, and Health Inequity

The historical legacies of racism and their perpetuation through structures of power produce outcomes that are detrimental to health and well-being. For example, devaluing people’s humanity as well as enforcing segregation through land use policy and red-lining results in denial of resources and services; stereotypes and seemingly innocuous classifications (nonwhite) can result in biased caregiving and medical research and unacceptable standards of care; criminalizing poverty and rationalizing police violence diverts attention from the social protections necessary to support people where they live and throughout the course of their lives.

These dimensions of racism, coupled with narratives associated with individualism (responsibility) and free markets (denial of corporate responsibility) produce disadvantage over time, slowly, dynamically, in undetectable ways.

These disadvantages remain unobserved, ongoing forms of violence, e.g., the permanent effects of polluting sites, the daily representations of racist stereotypes, burdens of poverty, and systematic neglect of social infrastructure.

Public health is often imprisoned in the values and frames of these dominant narratives. Its unremarked public narrative themes center on managing individual diseases and technocratic remedial responses to public health crises. Its target of intervention is often “factors” or “forces,” thereby addressing the consequences instead of the root causes that generate health inequity. While these public health responses are necessary and undertaken for
many legitimate reasons, they are ultimately insufficient for engaging with health inequity.

Furthermore racism, seeped within the framework of biomedical paradigm, creates a public narrative that not only blames the individual for making wrong “lifestyle” choices, but also suggests that the cultures of oppressed racial and ethnic groups are responsible for their own poorer health outcomes.

In short, public health needs a compelling story of itself that renders the social and political determinants of health visible and rooted in health inequity. Public health needs a public narrative that is based on principles and values of social justice. It needs to advance the health and well-being of the constituencies it serves—especially those oppressed, excluded, marginalized populations that are dispossessed and exploited by corporate interests and
public policies that perpetuate a racialized inequitable society.

What Is Needed

Shifting dominant public narrative patterns (not merely thoughts but practices) are central to reclaim public health’s social justice legacy in at least two ways.

The first includes creating closer ties between public health and social movements for racial, economic, and social equality, and mobilizing a population for transformation.
The second is by telling its story in ways that move and motivate both constituents and colleagues. The purpose is to make racial and social injustices that perpetuate health inequity visible, and to support cultural and political change for social justice.

An effective, compelling public narrative is essential to transform power, end white privilege, and provide meanings that will galvanize possibilities for equitable cultural change.

Apart from political courage and imagination, success requires a well-resourced network to explore how images and cultural representations can expand space for critical thought with different values. The objective is to grasp and present ideas outside of the institutionalized systems of research, analysis, norms, and discourse.

Richard Healey, co-director of the Grassroots Policy Project, describes a fundamental prerequisite for beginning to reclaim a narrative: “A strategy… with a clear political direction and values connected to health equity and not only a more compelling worldview connected to social justice, but an infrastructure to support it.”

The time is ripe because the pace of social disintegration is increasing thereby making dominant narratives more incoherent and abstract.

The Report

In the report, we present narratives and core themes that surfaced alongside ideas about how disrupting or countering particular narratives could advance health equity.

The report is not meant to be instructive or decisive but rather an exploratory, groundwork piece upon which further, deeper narrative strategy can be built.

This two-day convening moved participants through a sequential but iterative process. Participants first discussed narratives that countered and advanced racial justice, then examined how these and other narratives impacted health equity, and continued to examine the intersections between public narratives, racial justice, and health equity. This process produced extensive content from panels and work groups and this report is not a conclusion of any sorts, instead we intend to present major themes, challenges, and opportunities that emerged over the convening. The summary will allude to, but not be able to fully capture the complexity, depth, and idiosyncrasies discussed.

1 Forward
3 Introduction
6 The Importance of Narrative Power in Racial Justice
10 How Narrative Strategies Impact and Advance Health Equity
14 Exploring the Intersection
19 Narrative Change Strategies and Approaches
21 Themes and Narrative Cornerstones
24 Moving Forward: Challenges and Opportunities
25 Conclusions and Next Steps
27 Appendix A: List of Participants
28 Appendix B: Selected Resources
30 Endnotes